Healthcare Provider Details

I. General information

NPI: 1447276969
Provider Name (Legal Business Name): REZA SAFFARI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BRYANT WILLIAMS DR
KLAMATH FALLS OR
97601-1120
US

IV. Provider business mailing address

8778 NW RYAN ST
PORTLAND OR
97229-9182
US

V. Phone/Fax

Practice location:
  • Phone: 503-753-6675
  • Fax:
Mailing address:
  • Phone: 503-753-6675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD8237
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN23011
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4906T
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: